Pennsylvania Archives

Record Submission Forms

 

 

***NOTE***
These forms are for genealogical and historical records only.
DO NOT ENTER ANY INFORMATION ON LIVING INDIVIDUALS. IT WILL NOT BE POSTED
Please transcribe the full record, if you do not have the full record or all the facts required, please do not use this form.

Pennsylvania USGenWeb Archives Birth Certificates
Click here for information about these forms. (Opens a New Browser)
Use this form to automatically create and send your ancestors birth records to the Pennsylvania USGenWeb Archives
formatted for acceptance in the USGenWeb Archives Project. Or you can send your file by email to the
Archives Manager for your county (Addresses below)
An asterisk {*} next to a field means it is required, please double check before submitting.
Your tab key will work to move between the fields.
Your Email Address:    
Your First Name-Submitter: Your Last Name-Submitter:

Name (First, Middle) Last Name

Date Of Birth:
Month: Day: Year: *
Time Of Birth 
Place Of Birth:      

County Of Birth: *
Gender:   Race

Parent's Residence:  
Mothers Name (First Middle) Mothers Maiden Name
Age:  
Mother's Place Of Birth: 

Fathers Name (First Middle) Fathers Last Name
Age:  
Father's Place Of Birth 

Name Of Hospital: 
Name of Doctor:    
Source Of Record: 

Certificate No: 
Any Other Information On Record Enter Below:  

Enter Any Additional Comments: 

County or Counties Where File is to be Posted:
Required

Optional

Optional

If you want a copy of this sent to your email check here: 


(Before you submit please note, we can not provide you with records, if you are looking for a record please click here.
These forms are for sharing records which you already have in your possession.)

 

USGenWeb Archives State File Manager: Joe Patterson


USGenWeb Archives


PAGenWeb


USGenWeb

USGenWeb Archives

PAGenWeb Project

USGenWeb Project

 

Record Submission Forms For Other States
Record Submission Forms For Other States Mirror Site
Record Submission Forms For Other States Mirror Site


Problems or Comments about these forms contact Debra Crosby
Created by David Crosby Copyright 2002 - Present